Provider Demographics
NPI:1841798667
Name:DEVANSH LAB WERKS,INC
Entity Type:Organization
Organization Name:DEVANSH LAB WERKS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SUDHAKAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KANCHARLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-994-8266
Mailing Address - Street 1:234 AQUARIUS DR STE 111
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5867
Mailing Address - Country:US
Mailing Address - Phone:205-994-8266
Mailing Address - Fax:205-201-4797
Practice Address - Street 1:234 AQUARIUS DR STE 111
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-5867
Practice Address - Country:US
Practice Address - Phone:205-994-8266
Practice Address - Fax:205-201-4797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-26
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL01D2141620291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL01D2141620OtherCLIA CERTIFICATE